Bedside Lung Ultrasound As A Predictor Of The Extubation Readiness In Preterm Infants

2021 ◽  
Author(s):  
Veronica M. Samedi ◽  
Kaarthigeyan Kalaniti ◽  
Sibasis Daspal
Keyword(s):  
Preterm Infants ◽  
Lung Ultrasound

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

2021 ◽  
pp. 1-13
Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Imaging Method ◽  
Chronic Lung Diseases ◽  
Pleural Line ◽  
Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

scholarly journals Prediction of extubation readiness using lung ultrasound in preterm infants

2021 ◽  
Author(s):  
Reem M. Soliman ◽  
Yasser Elsayed ◽  
Reem N. Said ◽  
Abdulaziz M. Abdulbaqi ◽  
Rania H. Hashem ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Lung Ultrasound

Lung Ultrasound in Bronchopulmonary Dysplasia: Patterns and Predictors in Very Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Victoria Aldecoa-Bilbao ◽  
Mar Velilla ◽  
Marta Teresa-Palacio ◽  
Carla Balcells Esponera ◽  
Ana Herranz Barbero ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Lung Ultrasound ◽  
Respiratory Support ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Pleural Line ◽  
Respiratory Management ◽  
Postmenstrual Age ◽  
Severity Of The Disease

<b><i>Introduction:</i></b> Lung ultrasound (LUS) is useful for respiratory management in very preterm infants (VPI), but little is known about the echographic patterns in bronchopulmonary dysplasia (BPD), the relation between the image findings, and the severity of the disease and its long-term outcomes. We aimed to describe LUS patterns in BPD and analyze the accuracy of LUS to predict the need for respiratory support at 36 weeks postmenstrual age (PMA) in VPI. <b><i>Methods:</i></b> Preterm infants ≤30.6 weeks of gestational age were recruited. LUS was performed at admission, at 7th, and 28th day of life (DOL) with a standardized protocol (6 zones: anterior, lateral, and posterior fields). Clinical data, respiratory outcomes, and image findings were recorded. <b><i>Results:</i></b> Eighty-nine patients were studied. Infants with BPD had significantly higher LUS score at admission, at 7th, and 28th DOL. Patients with BPD exhibited more consolidations and pleural line abnormalities at 7th and 28th DOL than those without BPD (<i>p</i> &#x3c; 0.001), regardless of the definition used for BPD. LUS at 7th DOL predicted <i>NICHD 2001-BPD</i> with <i>R</i><sup>2</sup> = 0.522; AUC = 0.87 (0.79–0.94), <i>p</i> &#x3c; 0.001, and <i>Jensen 2019-BPD</i> with <i>R</i><sup>2</sup> = 0.315 (AUC = 0.80 [0.70–0.90], <i>p</i> &#x3c; 0.001). A model including mechanical ventilation &#x3e;5 days, oxygen therapy for 7 days and LUS score at 7th DOL accurately predicted the need for respiratory support at 36 weeks PMA (<i>R</i><sup>2</sup> = 0.655, <i>p</i> &#x3c; 0.001) with an AUC = 0.90 (0.84–0.97), <i>p</i> &#x3c; 0.001. <b><i>Conclusion:</i></b> LUS score, pleural line abnormalities, and consolidations can be useful to diagnose BPD in VPI and to predict its severity after the first week of life.

Lung ultrasound in preterm infants with respiratory distress: experience in a neonatal intensive care unit

2019 ◽  
Vol 179 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Rebeca Gregorio-Hernández ◽  
María Arriaga-Redondo ◽  
Alba Pérez-Pérez ◽  
Cristina Ramos-Navarro ◽  
Manuel Sánchez-Luna
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound

scholarly journals The role of lung ultrasound in preterm neonates with respiratory distress in neonatal intensive care unit

2021 ◽  
Vol 8 (8) ◽  
pp. 284-288
Author(s):  
Sidhant Swarup ◽  
Rakesh Panigrahi ◽  
Suryakanta Swain ◽  
Hemant Agrawal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Preterm Neonates ◽  
Point Of Care Ultrasound

Introduction: Up to 29% of late preterm babies suffer from respiratory distress due to which they need to be admitted to neonatal intensive care unit (NICU). Point-of-care ultrasound is a useful tool in critical neonate care, providing valuable information without any risk of ionizing radiation to the newborn. Materials and Method: This mono-centric, descriptive, and prospective study was conducted in NICU. Preterm newborns of less than 36 weeks with respiratory distress at birth on non-invasive ventilation were recruited. A lung ultrasound was performed at first 12 h of life and followed till their discharge. Main outcomes need for surfactant treatment. Results: Sixty preterm infants (median gestational age: 29 weeks) were recruited. Newborn in the surfactant group requiring ultrasound and intervention was significantly higher than in no surfactant group (p<0.0001). In 15 newborns who received surfactant, the first dose was administered at a median age of 4.5 h. In 13 of these 15 newborns, the lung ultrasound scan was subsequently repeated an average of 2 h (Standard deviation or SD: 2) On average, the second dose of surfactant was administered at 24 h of life (SD: 9). Conclusion: Early lung ultrasound in preterm infants with respiratory distress appears to be a useful tool with no adverse effects for the patient. It allows a better assessment of respiratory distress by detecting patients with a greater risk of requiring surfactant or mechanical ventilation, even before oxygenation criteria.

scholarly journals LUNG ULTRASOUND SCORE AND DIURETICS IN PRETERM INFANTS BORN BEFORE 32 WEEKS

2020 ◽  
Author(s):  
Almudena Alonso Ojembarrena ◽  
Alfonso Mar a Lechuga Sancho ◽  
Patricia Morales Arandojo ◽  
Silvia Acu as Soto ◽  
Rosa L pez de Francisco ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Lung Ultrasound ◽  
Ultrasound Score

A Lung Ultrasound Severity Score Predicts Chronic Lung Disease in Preterm Infants

2019 ◽  
Vol 36 (13) ◽  
pp. 1357-1361 ◽  
Author(s):  
Mohamed Abdelmawla ◽  
Deepak Louis ◽  
Michael Narvey ◽  
Yasser Elsayed
Keyword(s):  
Lung Disease ◽  
Preterm Infants ◽  
Sensitivity And Specificity ◽  
Gestational Age ◽  
Chronic Lung Disease ◽  
Severity Score ◽  
Lung Ultrasound ◽  
Characteristic Curve ◽  
Preterm Neonates ◽  
Predictive Values

Objective To test the hypothesis that a lung ultrasound severity score (LUSsc) can predict the development of chronic lung disease (CLD) in preterm neonates. Study Design Preterm infants <30 weeks' gestational age were enrolled in this study. Lung ultrasound (LUS) was performed between 1 and 9 postnatal weeks. All ultrasound studies were done assessing three lung zones on each lung. Each zone was given a score between 0 and 3. A receiver operating characteristic curve was constructed to assess the ability of LUSsc to predict CLD. Results We studied 27 infants at a median (interquartile range [IQR]) gestational age and birth weight of 26 weeks (25–29) and 780 g (530–1,045), respectively. Median (IQR) postnatal age at the time of LUS studies was 5 (2–8) weeks. Fourteen infants who developed CLD underwent 34 studies. Thirteen infants without CLD underwent 30 studies. Those who developed CLD had a higher LUSsc than those who did not (median [IQR] of scores: 9 [6–12] vs. 3 [1–4], p < 0.0001). An LUSsc cutoff of 6 has a sensitivity and specificity of 76 and 97% and positive and negative predictive values of 95 and 82%, respectively. Adding gestational age < 27 weeks improved sensitivity and specificity to 86 and 98% and positive and negative predictive values to 97 and 88%. Conclusion LUSsc between 2 and 8 weeks can predict development of CLD in preterm neonates.

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